Methods and devices for controlling articulation

Abstract

Methods and devices are provided for controlling movement of a working end of a surgical device. In one embodiment, methods and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting. In other embodiments, a single cable actuator is provided and is movable between a first position, in which it is effective to rotate an end effector without actuating (i.e., closing and firing) the end effector, and a second position, in which it is effective to actuate the end effector without rotating the end effector. In other aspects, methods and devices are provided for moving a flexible neck formed on a distal end of an accessory channel for use with an endoscope. Movement of the flexible neck can be used to control positioning of a tool extending through the flexible neck.

What is claimed is: 
     
       1. A surgical device, comprising:
 an elongate shaft having a proximal end with a handle movably coupled thereto, and a distal end having a flexible neck extending therefrom with an end effector coupled to a distal end of the flexible neck, wherein the handle and the flexible neck are operatively associated such that movement of the handle is mimicked by the flexible neck; and 
 a rotating member coupled to the handle, wherein the rotating member is configured to rotate relative to the handle in a distal position to effectuate rotation or actuation of the end effector, wherein the rotating member is configured to be retracted from the distal position to a proximal position relative to the handle, wherein the rotating member is configured to rotate relative to the handle in the proximal position to effectuate the other of rotation or actuation of the end effector, and wherein actuation fires at least one fastener from the end effector, causes the end effector to cut tissue, or both fires at least one fastener from the end effector and causes the end effector to cut tissue. 
 
     
     
       2. The device of  claim 1 , wherein the mimicking movement is proportional. 
     
     
       3. The device of  claim 1 , wherein the handle is adapted to articulate relative to the proximal end of the elongate shaft. 
     
     
       4. The device of  claim 3 , wherein the handle is coupled to the proximal end of the elongate shaft by a joint selected from the group consisting of a ball and socket joint, a hinge joint, and a flexing joint. 
     
     
       5. The device of  claim 1 , wherein the handle and the flexible neck are operatively associated by an actuator extending between the handle and the flexible neck, the actuator being configured to transfer movement from the handle to the flexible neck. 
     
     
       6. The device of  claim 5 , wherein the actuator comprises at least one cable extending along a length of the elongate shaft and effective to apply a force to the flexible neck to move the flexible neck in at least one plane of motion. 
     
     
       7. The device of  claim 6 , wherein the at least one cable is formed from an electroactive polymer material, and wherein movement of the handle is effective to selectively deliver energy to the at least one cable to cause the at least one cable to axially contract and radially expand and thereby cause at least one of the flexible neck to mimic the motion of the handle. 
     
     
       8. The device of  claim 6 , wherein the at least one cable comprises a plurality of cables extending along a length of the elongate shaft, each cable being effective to apply a force to the flexible neck to move the flexible neck in a different plane of motion. 
     
     
       9. The device of  claim 8 , wherein the plurality of cables are equally spaced apart from one another around a circumference of the actuator. 
     
     
       10. The device of  claim 8 , wherein the plurality of cables comprise at least three cables extending along a length of the elongate shaft. 
     
     
       11. The device of  claim 8 , wherein at least one of the handle and the plurality of cables include a locking mechanism associated therewith and configured to maintain at least one of the handle and the plurality of cables in a fixed position. 
     
     
       12. The device of  claim 1 , wherein the elongate shaft includes a central lumen extending therethrough along a length thereof, the central lumen being adapted to receive a tool therethrough. 
     
     
       13. The device of  claim 12 , wherein the elongate shaft includes a mating element formed on and extending along a length of an external surface thereof for mating to a complementary mating element formed on a sleeve adapted to receive an endoscope. 
     
     
       14. A surgical device, comprising:
 an elongate shaft having a proximal end and a distal end with a flexible neck defining a working end of the device and having an end effector coupled thereto, the flexible neck being made flexible by a plurality of slits formed therein; 
 a handle movably coupled to the proximal end of the elongate shaft and operatively associated with the flexible neck such that movement of the handle is effective to cause the flexible neck to articulate in multiple planes; 
 a rotating member coupled to the handle and being movable in a proximal direction relative to the elongate shaft from a first position relative to the elongate shaft to a second position relative to the elongate shaft, the rotating member being rotatable relative to the elongate shaft while remaining in the first position relative to the elongate shaft to rotate the end effector, and the rotating member being rotatable relative to the elongate shaft while remaining in the second position relative to the elongate shaft to actuate the end effector, wherein actuation fires at least one fastener from the end effector, causes the end effector to cut tissue, or both fires at least one fastener from the end effector and causes the end effector to cut tissue; and 
 a translating member coupled to the handle and being effective to move the rotating member between the first and second positions. 
 
     
     
       15. The device of  claim 14 , wherein the handle is operatively associated with the flexible neck by a plurality of cables spaced circumferentially about the elongate shaft and extending between the handle and a distal end of the flexible neck, the plurality of cables being configured to slide relative to an axis of the elongate shaft in response to movement of the handle and to tension the flexible neck to cause the flexible neck to articulate. 
     
     
       16. The device of  claim 15 , further comprising a locking mechanism positioned to engage at least one of the handle and the plurality of cables to lock the handle and the plurality of cables in a fixed position and thereby maintain the flexible neck in a fixed position. 
     
     
       17. A surgical device, comprising:
 a flexible elongate shaft having proximal and distal ends, the distal end having an end effector coupled thereto; 
 a plurality of cables spaced circumferentially about the elongate shaft and extending between the proximal and distal ends of the elongate shaft, the plurality of cables being configured to slide relative to an axis of the elongate shaft and to apply tension to the elongate shaft to cause at least a portion of the elongate shaft to flex and bend; 
 a rotating member that is movable in at least one of proximal and distal directions relative to the elongate shaft along a longitudinal axis of the elongate shaft, wherein the rotating member is effective to rotate about the longitudinal axis of the elongate shaft to selectively rotate and actuate the end effector, wherein actuation fires at least one fastener from the end effector, causes the end effector to cut tissue, or both fires at least one fastener from the end effector and causes the end effector to cut tissue; and 
 a locking mechanism coupled to the elongate shaft and positioned to engage the plurality of cables to lock the plurality of cables in a fixed position and thereby maintain the elongate shaft in a fixed position. 
 
     
     
       18. The device of  claim 17 , wherein the elongate shaft is configured to passively flex and bend when it is inserted through a tortuous lumen. 
     
     
       19. A surgical method, comprising:
 inserting an elongate shaft into a body lumen to position a flexible neck coupled to a distal end of the elongate shaft adjacent to tissue to be treated, a distal end of the flexible neck having an end effector coupled thereto; 
 moving a handle pivotally coupled to a proximal end of the elongate shaft to cause the flexible neck to mimic the motion of the handle; 
 selecting one of first and second positions for a rotating member, the second position being retracted from the first position at a different axially-aligned position than the first position along a longitudinal length of the elongate shaft; and 
 rotating the rotating member relative to the elongate shaft in the selected one of the first and second positions, wherein rotating the rotating member in the first position causes rotation of the end effector and rotating the rotating member in the second position causes at least one of firing at least one fastener from the end effector, and cutting tissue engaged by the end effector. 
 
     
     
       20. The method of  claim 19 , wherein the mimicking motion is proportional. 
     
     
       21. The method of  claim 19 , wherein the flexible neck mirrors movement of the handle. 
     
     
       22. The method of  claim 19 , wherein movement of the flexible neck directly corresponds to movement of the handle. 
     
     
       23. The method of  claim 19 , wherein the handle is pivotally articulated about the proximal end of the elongate shaft to cause the flexible neck to mimic the motion of the handle. 
     
     
       24. The method of  claim 19 , wherein inserting the elongate shaft comprises mating the elongate shaft to a sleeve disposed around an endoscope, and sliding the elongate shaft along the sleeve to position the flexible neck adjacent to a distal end of the endoscope. 
     
     
       25. The method of  claim 24 , further comprising inserting a tool through a central lumen formed in the elongate shaft to position a working end of the tool in proximity to a distal end of the flexible neck such that moving the handle pivotally coupled to a proximal end of the elongate shaft causes the working end of the tool to move as the flexible neck proportionally mimics the motion of the handle.